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2025 CPT code 33997

Removal of a percutaneous right heart ventricular assist device (VAD) and venous cannula at a separate session from insertion.

Refer to the current CPT guidelines and official coding manuals for specific instructions on the use of 33997.Modifier 59 may be required if the removal is on the same day as a related procedure.

Modifier 59 may be appended if the removal is performed on the same day as insertion, but in a distinct procedural session.

Removal of the VAD must be medically necessary, such as to prepare the patient for a heart transplant, due to device malfunction, or after the patient has been sufficiently stabilized.Documentation must support the medical necessity.

The surgeon is responsible for the removal of the VAD and cannula. This includes prepping the patient, removing the dressing and sutures, carefully extracting the device and cannula, controlling bleeding at the insertion site and applying a sterile dressing.

IMPORTANT:For removal of left or right heart VAD via open approach, see appropriate vessel repair codes (e.g., 35206, 35226, 35286, 35371).If removal occurs on the same day as insertion, use 33992 or 33997 with modifier 59.

In simple words: The doctor removes a small pump (VAD) and tube from a vein,placed earlier to help the heart pump blood. This removal happens on a different day than when the pump was first put in, usually after the pump has helped the patient get better or if they are getting a new heart.

This CPT code 33997 describes the removal of a percutaneous right heart ventricular assist device (VAD) and its associated venous cannula.This procedure is performed at a separate and distinct session from the initial VAD insertion.The removal involves meticulous extraction of the entire device, including the cannulas. It's typically undertaken after the VAD has aided in patient stabilization or when the patient is scheduled for a heart transplant or artificial heart implantation.

Example 1: A patient with severe heart failure receives a percutaneous right heart VAD. After several weeks of stabilization, the patient is listed for a heart transplant.Code 33997 is used to bill for the removal of the VAD prior to the transplant., A patient undergoes percutaneous right heart VAD insertion. Due to complications, the VAD needs to be removed on a separate day and replaced with a new device.Code 33997 is used for the removal, and the insertion is billed using a different code., A patient with a percutaneous right heart VAD experiences device malfunction. The VAD is removed as an emergency procedure several weeks after placement. Code 33997 is applied to bill for this removal procedure.

* Operative report detailing the removal procedure.* Preoperative and postoperative assessments of the patient's hemodynamic status.* Documentation of the indication for VAD removal (e.g., preparation for transplant, device malfunction, patient stabilization).* Imaging studies (if performed) to assess VAD position and confirm removal.

** Always refer to the most up-to-date CPT manual and payer-specific guidelines for complete and accurate coding information.Consider any local coverage determinations (LCDs) that may affect reimbursement.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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